1 Summary

1.1 Creation of a joint service with the NHS for children with disabilities in new build shared accommodation.

1.2 The following decisions are sought:

i) To approve the service development for children and young people with severe learning disabilities and/or challenging behaviour

ii) To welcome this innovative scheme as a positive example of joint work with the National Health Service.

2 Reason

2.1 To seek approval of revised service development for residential respite care for children and young people with severe learning disabilities and/or challenging behaviour.

2.2 This scheme supports Aim 1 (Maximising Life Opportunities) and Aim 5 (Improving Services) of the Corporate Strategy by providing a respite service for children with disabilities in a building that will meet the current registration standards. The provision of respite care - including residential respite - offers children with disabilities increased leisure opportunities and enables families to have a break from caring. The service often enables the disabled child to remain within the family home rather than having to move away to a long-term residential placement.

2.3 Race Relations (Amendment) Act - the Government Regulations and Inspection arrangements specify requirements concerning racial (and other forms of) discrimination. Compliance with the Act in terms of carrying out an Impact Assessment is confirmed forming part of the programme of work relating to the Department's Service, and the Service Plans in the Children and Families sector.

3 Other options considered and rejected

3.1 Purchasing of specialist service from an external provider

3.2 Continuation of service on current site

4. Conflicts of Interest declared by the decision-maker or other Executive Member consulted

None

5. Dispensation granted by the Standards Committee

None

6. Reason(s) for the matter being dealt with if urgent

Not applicable

Approved by: Date of decision:

Councillor Felicity Hindson

1 Summary

1.1 This report is to update the Executive Member on the current position of the development of the Programmed Care Unit in Basingstoke for children with severe disabilities. This new-build unit will replace an existing social care respite service at Verdi Close in Basingstoke (Social Services) and a health respite service at Erdsley House, Basingstoke (North Hampshire Health Trust) There will be places for 9 children in total - 5 social care and 4 health care - although there will be some flexibility of use according to need.

2 Links to Corporate Strategy

2.1 This scheme supports Aim 1 (Maximising Life Opportunities) and Aim 5 (Improving Services) of the Corporate Strategy by providing a respite service for children with disabilities in a building that will meet the current registration standards. The provision of respite care - including residential respite - offers children with disabilities increased leisure opportunities and enables families to have a break from caring. The service often enables the disabled child to remain within the family home rather than having to move away to a long-term residential placement.

3 Impact Assessment

3.1 Race Relations (Amendment) Act - the Government Regulations and Inspection arrangements specify requirements concerning racial (and other forms of) discrimination. Compliance with the Act in terms of carrying out an Impact Assessment is confirmed forming part of the programme of work relating to the Department's Service, and the Service Plans in the Children and Families sector.

4 Background

4.1 The facilities at Verdi Close, the existing social care provision owned by Hampshire County Council have become outdated and inadequate in terms of physical environment and space. It would not be cost effective to bring the building up to standard because the rooms would still be too small to meet the current rigorous registration requirements of minimum standards

4.2 Within Objective 6 of the Quality Protects Programme, which identified the support that should be given to children with disabilities and their families, local authorities were requested to improve services to ensure better community based provision was available. It is acknowledged that respite care provides a crucial element of the support services for children with disabilities and their families. The provision needs to be local so that families can benefit from the disabled child having overnight respite, and not spend all their carer break time travelling to and from the unit. There is no other residential respite provision (within easy reach of the Basingstoke area). It is estimated that some 60 children and young people known to Social Services will use the service.

4.3 The opportunity for innovative commissioning was taken sometime ago between Social Services and the then Health Authority. Work has continued through the various changes within the agencies and there is a continued commitment to provide for the first time a jointly commissioned integrated service for children and young people with severe disabilities/and or challenging behaviour in Hampshire.

4.4 The unit will have a single manager, and the overall running and management will be overseen by a Joint Management Board.

4.5 There has been significant parental support and involvement for this project. Parents have been part of the key decision making at project meetings and are represented on the Steering Group.

4.6 Although the scheme has presented a number of significant challenges during its development, it is clear that this type of joint commissioning approach will bring benefits to families over the separate health and social care provision that currently exists. The National Service Framework for Children, Young People and Maternity Services identifies key delivery improvement outcomes for children. These include better co-ordinated services; better involvement of people in decisions about their care; better at achieving good results and outcomes for children and young people. Standard 8 relates specifically to children and young people with disabilities and complex health needs which includes ensuring easy access to a range of health/social care services; early identification and integrated diagnosis and assessment; good support for parents and support to strengthen families.

5 Costs

5.1 The capital cost for the scheme is £2.044m in total. The County Council has agreed to contributed £395,000 (made up of an original contribution of £190,000, and an additional £180,000 approved by the Leader in March 2004, both sums from the capital receipt of the proposed sale of Verdi Close); together with an extra £25,000 agreed in February 2005.

The National Health Service is to contribute £950,000, this being the capital receipt from the sale of Erdsley House.

Summary

Hampshire County Council - £395,000*

North Hampshire Hospitals' Trust - £950,000**

Learning Disabilities Development Fund - £300,000

Strategic Health Authority - £325,000

North Hampshire Hospitals' Trust - £ 74,280***

* contribution from the capital receipt to be realised for Verdi Close and £25k from Social Services budget

** contribution from the capital receipt to be realised for Erdsley House (current health respite unit)

*** funding from Trust towards recently identified shortfall

5.2 The Leader approved the County Council's increased contribution of £395,000; and has confirmed satisfaction with the nature of the County Council's involvement in the scheme. This was authorised in the Routine Items schedule following prior discussion with the Leader by officers from the Property Business and Regulatory Services at a meeting on the 17^th February 2005.

5.3 The North Hampshire Hospitals' Trust have been informed in writing that any further escalation in building costs will need to be borne solely by the Trust.

5.4 The revenue implications for Social Services of running a 5 bed programmed care unit have been considered in the context of the historical revenue budget allocation for the Verdi Close respite unit. In terms of the staffing arrangements opportunities have been taken to realign budgets to meet recent increase in care needs of the children and to maximise flexibility of staff working patterns.

5.5 Current calculations indicate an overall revenue shortfall in the range of £120,000 to £133,000. This commitment has been built into the Children and Families Social Services budget commitments for the financial year 2005/06 as a full year cost, which will be adjusted to reflect the appropriate level of part-year costs when the opening date of the new unit is confirmed.

5.6 This overall figure, which will be finalised shortly, is based both on the staffing implications, and on a working assumption that capital charges for depreciation and interest may be made to Social Services (amounting to £60,000), together with an apportionment of premises and running costs (approximately £43,000). Negotiations with the Trust continue.

5.7 It is envisaged that these costs will be partially offset (from 2006/07) as some children will be able to return home from expensive non county placements; the high care demands upon their parents or other carers being reduced by the availability of this new service.

RECOMMENDATIONS

It is recommended that the Executive Member

1. Approves the service development for children and young people with severe learning disabilities and/or challenging behaviour

2. Welcomes this innovative scheme as a positive example of joint work with the National Health Service.

Section 100 D - Local Government Act 1972 - Background Documents

The following documents discuss facts or matters on which this report, or an important part of it, is based and have been relied upon to a material extent in the preparation of this report.

NB the list excludes:

1. Published works

2. Documents which disclose exempt or confidential information as defined in the Act

NONE